An Soomin, Eo Wankyu, Kim Seol Bin, Lee Sookyung
Department of Nursing, Dongyang University, Gyeongbuk, Republic of Korea.
Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Medicine (Baltimore). 2024 Nov 22;103(47):e40665. doi: 10.1097/MD.0000000000040665.
The basal metabolic rate (BMR) is a crucial indicator of the body's energy expenditure at rest and is essential for understanding metabolic needs. This retrospective study evaluated the prognostic significance of BMR in 521 predominantly Asian patients with stage I-III gastric cancer who underwent curative-intent resection. BMR was calculated using the Food and Agriculture Organization/World Health Organization/United Nations University (FWU BMR) equation. Multivariate Cox regression analysis identified FWU BMR as a significant predictor of overall survival (OS) (P < .001). Fractional polynomial modeling revealed a linear relationship between FWU BMR and OS, with higher values correlating with lower mortality risk. The FWU model, which included FWU BMR along with other clinical variables, showed superior predictive performance (C-index: 0.815, iAUC: 0.775) compared to that of the same model lacking BMR. Additionally, although the differences were not statistically significant, the FWU model also outperformed those using the BMR derived from alternative equations, including the Harris-Benedict equation. The nomogram, based on the FWU model, demonstrated good calibration. These findings suggest that the FWU BMR is a valuable prognostic factor in patients with gastric cancer post-resection, enhancing predictive accuracy and aiding in personalized post-surgical care. However, further validation in diverse populations is required.
基础代谢率（BMR）是身体静息能量消耗的关键指标，对于理解代谢需求至关重要。这项回顾性研究评估了BMR在521例主要为亚洲的I - III期胃癌患者中的预后意义，这些患者接受了根治性切除手术。BMR采用粮农组织/世界卫生组织/联合国大学（FWU BMR）公式计算。多变量Cox回归分析确定FWU BMR是总生存期（OS）的显著预测因素（P < 0.001）。分数多项式模型显示FWU BMR与OS之间存在线性关系，值越高与死亡风险越低相关。包含FWU BMR以及其他临床变量的FWU模型与缺乏BMR的相同模型相比，显示出更好的预测性能（C指数：0.815，iAUC：0.775）。此外，尽管差异无统计学意义，但FWU模型也优于使用包括哈里斯 - 本尼迪克特方程在内的替代方程得出的BMR的模型。基于FWU模型的列线图显示出良好的校准。这些发现表明，FWU BMR是胃癌切除术后患者的一个有价值的预后因素，提高了预测准确性并有助于个性化的术后护理。然而，需要在不同人群中进行进一步验证。
